F.E.A.S.T's Around The Dinner Table forum

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hopefulyetscared
My D has been at healthy weight for a while now. We are just trying to maintain and grow at the appropriate rate (and have been successful at it).

Over the past year and a half she has had the same shake every morning for breakfast. For the past few weeks she has tried eating other foods for breakfast and although she feels like it is "a lot" of food, she does eat it.

My problem is that the shakes were really high in fat which I knew she needed when she was gaining weight. (Probably 20-22 grams) And D does not know what was in them.
Now her breakfasts are just as caloric but have less fat (probably 12-15 grams).
Is this a big difference?

I'm also trying to vary her snacks and increase fat there to make up for getting less at breakfast.

I'm just wondering if she maintains her weight but has less fat in her diet, will it impact her brain recovery?

She is still so mentally in the ED. Over the last month I really have been challenging ED with lots of variety and fear foods. So she has been at a heightened state of anxiety, but I'm trying to determine is this just from being challenged or can changing breakfast impact it. I read here how important lots of fat is for recovery, I'm just struggling with how much is needed?

I am looking forward to the day when I can be a source of information and support to others going though this awful disease. I truly am grateful for this forum. It is the only place I can turn to where I know you all "get it".

As always, thanks for your thoughts....

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EC_Mom
I'm figuring other people here will have lots to say about this, but here's the thing. If she is still mentally in the ED, then she is likely not at a healthy weight FOR HER. If she is afraid of eating, she isn't done with refeeding.

There is no need, in my view, for a patient to STOP gaining weight until eating becomes much easier. Their brains might need more fat on their bodies than they had before they got sick. My D gained weight beyond what some people might think is "enough", but then she started getting more normal, asking for food, enjoying food, etc. So why would you reduce the fat/calories in the shakes at all? Sure it's good to shake up the foods and reintroduce fear foods, but if it's still a struggle then in my view it's not time yet to stop the refeeding model of "more fat AND more calories are all good".
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BattyMatty_UK
My son had a major problem with fat and it took some time to get him to eat it without resistance or anxiety. But once he was eating a properly balanced diet - i.e. including fats - his brain seemed to heal and he became much more 'normalised' in his thinking and behaviour. He found it easier to start on the so-called 'good fats' like oily fish, avocado, nuts, etc. What worked for us was a family 'behavioural contract' which helped my son face fear foods (and other outstanding issues) small step by small step. You can find out more on my blog below and also here: https://anorexiaboyrecovery.blogspot.co.uk/p/recovery-contract.html

The idea of the contract was to slowly nudge him in the right direction with incentives to try stuff out (not a bribe, more gentle encouragement). If something didn't work, we'd put it on hold and try again later, but the general trend was forwards and my son says it was the #1 thing that helped him to recover. Maybe something similar might work for you re. fats?
Bev Mattocks, mother of 24-year old male DX with RAN 2009, now recovered. Joined this forum in 2010 - it was a lifesaver.
 
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mamabear
Your daughter I believe is 13....
My advice from experience- do NOT back down on calories and fats. Fats are absolutely critical to recovery from ed. The fact that she is still anxious and having a hard time shows you that it is time to rip the bandaid off and push. Tackle all fear foods. Switch up breakfast. Switch up all meals and snacks. Your daughter very likely still has a ton of growing to do and hormones/puberty to keep going through. In my experience, my daughter started to really do super well once her BMI hit the low 20s and STAYED CONSTANT with slow little gain for growth. My daughter got sick at 10.5 and Was four feet 7 inches and around 68 pounds when diagnosed. Now she is 16.5, five feet 3.5 inches tall, and weighted in last week at 142. She doubled her body weight plus. She looks like a million bucks and has very much the Marilyn Monroe body going on. It is kind of crazy- I never would have believed it if I had a crystal ball. Obviously you have to find the weight that works for your daughter....but do not be scared of fats. there was a time when my daughter was around 14 that she started to look a little "round" in the face and belly/butt. I was freaking out a bit about her getting "too much" and my husband kept telling me to just stay the course and let her body adjust. Within a few months her weight did not change but her proportions did- everything went to the "right" place and we were able to sslllloooowwwlllyyy back off on calories and fats but it was a very gradual process. 

I don't like the word "maintain" when we are talking about kids in this age group. That number should not stay stagnant. It is a moving target. 
If your daughter pushes back- that means you are on track. It sucks to have to poke the beast again- but you want that beast GONE. Time is on your side- so give it hell.
Persistent, consistent vigilance!
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Torie
Hi HYS - As you may know, people can pretty much count on me to jump in and say, "She needs more weight! And she needs more fats!" 
  
But I don't remember your d's history so I'm not going to say that just yet.  You say her thinking is still very distorted.  But is it improving?  That's my main criterion: She should be improving, even if ever so s-l-o-w-l-y. (And of course it's never linear so there are always the unfortunate downward jigs in between the upward jags.)

I think a good rule of thumb might be a minimum of 30% calories from fats.  

Please keep us posted. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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